Saylor URL: http://www.saylor.org/books Saylor.org
parents that she had been feeling particularly good—her energy level was high and she was
confident in herself and her life.
One day Juliana was feeling so good that she impulsively quit her new job and left town with her
boyfriend on a road trip. But the trip didn’t turn out well because Juliana became impulsive,
impatient, and easily angered. Her euphoria continued, and in one of the towns that they visited
she left her boyfriend and went to a party with some strangers that she had met. She danced into
the early morning and ended up having sex with several of the men.
Eventually Juliana returned home to ask for money, but when her parents found out about her
recent behavior, and when she acted aggressively and abusively to them when they confronted
her about it, they referred her to a social worker. Juliana was hospitalized, where she was
diagnosed with bipolar disorder.
While dysthymia and major depressive disorder are characterized by overwhelming negative
moods, bipolar disorder is a psychological disorder characterized by swings in mood from overly
“high” to sad and hopeless, and back again, with periods of near-normal mood in between.
Bipolar disorder is diagnosed in cases such as Juliana’s, where experiences with depression are
followed by a more normal period and then a period of mania or euphoria in which the person
feels particularly awake, alive, excited, and involved in everyday activities but is also impulsive,
agitated, and distracted. Without treatment, it is likely that Juliana would cycle back into
depression and then eventually into mania again, with the likelihood that she would harm herself
or others in the process.
Bipolar disorder is an often chronic and lifelong condition that may begin in childhood.
Although the normal pattern involves swings from high to low, in some cases the person may
experience both highs and lows at the same time. Determining whether a person has bipolar
disorder is difficult due to the frequent presence of comorbidity with both depression and anxiety
disorders. Bipolar disorder is more likely to be diagnosed when it is initially observed at an early
age, when the frequency of depressive episodes is high, and when there is a sudden onset of the
symptoms (Bowden, 2001). [11]